Laparoscopic herniorrhaphy of bilateral inguinal herniae and an incidental Spigelian hernia with intra corporeal suturing of the Spigelian hernia neck: A case report

INTRODUCTION: A Spigelian hernia is a rare type of abdominal wall hernia occurring in an area of congenital or acquired defect. These hernias occur in an area called the Spigelian zone and are interparietal making for a difficult diagnosis on clinical exam. PRESENTATION OF CASE: A 74-year-old female presenting with bilateral inguinal herniae and a left sided Spigelian hernia. The repair was done laparoscopically with an intra-corporeal suture closing the Spigelian hernia neck. Her recovery was uneventful. DISCUSSION: The aetiology of Spigelian herniae remains nebulous. Due to their rarity and evasive nature on clinical exam, ultrasound imaging has become the first line in diagnosis. Open herniorrhaphy is still the most common technique, but laparoscopic repair is becoming more commonplace in the surgical armamentarium. CONCLUSION: Spigelian herniae are rare with non specific symptoms. We present the first case report of a laparoscopic repair of bilateral inguinal herniae and a left sided Spigelian hernia with intra-corporeal suturing of the Spigelian hernia neck.